Patrick Lewis, PharmD, Senior Director, Medical Affairs at Amryt Pharma discusses the treatment options for patients with acromegaly.



Acromegaly is a rare endocrine disorder due to excess levels of growth hormone (GH). In many cases, a benign tumor on the pituitary gland causes the excess of GH. Common symptoms include subtle skeletal overgrowth; soft tissue swelling (tongue, heart, kidney, colon, and vocal cords); unusually prominent forehead and heavy brow ridge; protruding lower jaw; overbite; skin thickening; increased shoe and ring size; hypertension; increased perspiration; headaches; paresthesia; and sexual dysfunction. However, due to the insidious nature at which acromegaly symptoms develop, there is an average diagnostic delay of 5.5 years.   

The first treatment option for acromegaly is surgery on the benign tumor.  If surgery is not an option or not successful, there are currently four orphan drugs approved to treat acromegaly. They either stimulate somatostatin receptors (octreotide, octreotide-oral, pasireotide) or inhibit GH receptors (pegvisomant). 

As noted by Dr. Lewis, first-line medical therapy are the injectable somatostatin receptor analogs (octreotide, pasireotide) but if the person cannot tolerate the injections but responds to treatment, oral octreotide is another option. Second and third-line therapies include pegvisomant or radiation therapy. 

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